Concourse Sentinel

Medicaid Integrity Analytics

πŸ“ŠOverviewπŸ₯ProvidersπŸ’ŠProcedures🚨WatchlistπŸ”Statistical Outliersβš–οΈCompareπŸ“ˆTrendsπŸ—ΊοΈGeography

Cross-Dataset

πŸ•ΈοΈEntity Networks🏠Home Healthβ›”Exclusions (LEIE)πŸ“‹Context & Disclaimers
πŸ‡ΊπŸ‡ΈAll States
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Kansas Medicaid Provider Spending

CMS T-MSIS data, 2018-2024

Concourse Sentinel connects to large-scale healthcare billing datasets β€” including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists β€” and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.

Cross-Dataset Analysis Available

Watchlist

76 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$8.4B

Total Claims

106.9M

Unique Providers

5.3K

Watchlist

455

76 highest/critical risk

Monthly Spending Trend
Top 10 Providers by Spending
View all providers β†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
T2016Habil res waiver per diem$1.7B4.2M
S5125Attendant care service /15m$1.2B11.0M
T2021Day habil waiver per 15 min$805.3M2.1M
T1019Personal care ser per 15 min$469.7M5.0M
T1040Comm bh clinic svc per diem$458.5M1.7M
T1000Private duty/independent nsg$298.7M621.9K
99213Office o/p est low 20 min$279.6M3.3M
H0036Comm psy face-face per 15min$258.6M2.6M
T2025Waiver service, nos$201.2M2.2M
T2046Hospice long term care, r&b$173.9M587.3K
View all procedures β†’